How much rates vary
Facilitymedian $214 · 10th to 90th $91 to $1,202Professionalmedian $174 · 10th to 90th $100 to $324
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $91.20 Median $134.90 Typical High $213.80 | Facility | None | $91.20 | $134.90 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $281.84 | Professional | None | $91.20 | $134.90 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $323.59 | Professional | None | $109.65 | $181.97 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $309.03 Typical High $1,412.54 | Facility | None | $134.90 | $309.03 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $331.13 | Professional | None | $128.82 | $194.98 | $331.13 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $331.13 | Professional | None | $128.82 | $208.93 | $331.13 |
Martin's Point Setting Facility Modifier None Typical Low $91.20 Median $134.90 Typical High $23,988.33 | Facility | None | $91.20 | $134.90 | $23,988.33 |
Martin's Point Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $281.84 | Professional | None | $91.20 | $134.90 | $281.84 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $295.12 | Professional | None | $147.91 | $208.93 | $295.12 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $60.26 Typical High $67.61 | Professional | 52 · Reduced service | $45.71 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $23.99 Typical High $26.92 | Professional | 53 · Discontinued | $18.20 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $89.13 Typical High $102.33 | Professional | 54 · Surgery only | $69.18 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $17.78 Typical High $20.42 | Professional | 55 · Aftercare only | $13.80 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.02 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.12 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $83.18 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $64.57 | $83.18 | $95.50 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $60.26 Typical High $67.61 | Professional | 52 · Reduced service | $45.71 | $60.26 | $67.61 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $23.99 Typical High $26.92 | Professional | 53 · Discontinued | $18.20 | $23.99 | $26.92 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $89.13 Typical High $102.33 | Professional | 54 · Surgery only | $69.18 | $89.13 | $102.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $17.78 Typical High $20.42 | Professional | 55 · Aftercare only | $13.80 | $17.78 | $20.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.02 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.12 | $12.02 | $13.49 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $83.18 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $64.57 | $83.18 | $95.50 |
Where Maine sits
The same service costs 3.8 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maine· 24th of 51
$178
AK $525KY $138
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.